Caries incidence and orthodontic treatment with fixed appliances

Abstract

abstract – One hundred and seventy‐three individuals receiving orthodontic treatment according to an edgewise‐light wire technique, wearing full band orthodontic appliances in one or both dental arches, were investigated to determine the incidence of dental caries at the end of the therapy. Topical application of sodium fluoride was used prior to, during, and after the period of active treatment. Thorough instruction in manual toothbrushing with a horizontal scrub technique was given. The carious state of the gingival enamel areas was assessed according to a proposed Caries Index system. The average period of treatment was 19.0 months. A reference group received no form of orthodontic treatment, no tooth‐brushing instruction, nor regular application of fluoride. The results indicate that, on an over‐all basis, the number of new enamel alterations was small, and the total caries frequency was not markedly influenced by the appliances. The vast majority of the carious lesions were observed in comparatively few patients. On the other hand, the distribution of the lesions was significantly different in the reference and in the experimental groups, both with regard to the individual tooth and the individual tooth surface. The bands had a protecting effect on all proximal surfaces and on the completely covered vestibular and lingual surfaces of the molars, while the partly covered vestibular and lingual surfaces of the anterior teeth were subject to an increased caries susceptibility in comparison with the reference subjects. However, most vestibular and lingual lesions were reversed by regular applications of fluoride, or eliminated by slight grinding.